The American Hospital Association's Health for Life framework embraces the need to engage patients and families, and contemplates hospitals' role in improving the overall health of their communities. In 2012, the AHA's Committee on Research focused on one aspect of this need: actively engaging health care users to improve outcomes and reduce costs.

The resulting report, "Engaging Health Care Users: A Framework for Healthy Individuals and Communities," urges hospitals to become more "activist" in their orientation and move "upstream;" that is, do more to engage patients and intervene before illness progresses. The report introduces a continuum for engagement, from information-sharing to partnerships, and recommends four different types of engagement:

  • Individual — Increase the skills, knowledge and understanding of patients and families about what to expect when receiving care.
  • Health care team — Promote shared understanding of expectations among patients and providers.
  • Organization — Encourage partnerships and integrate the patient and family perspective into all aspects of hospital operations.
  • Community — Expand the focus beyond the hospital setting and find opportunities to improve overall community health.

The report also includes case studies highlighting strategies that hospitals have deployed. In addition, the report looks at the roles of behavioral and mental health; health plans as major stakeholders in the engagement process; employers as drivers for creating a culture of health; new technologies; and social media as a means to enhance communication and networking with individuals and communities.

As we strive to reinvent the health care system, engaging families and patients requires that we move outside our comfort zone — acute, in-hospital management of episodes of illnesses — to rethink how we interact with our patients and communities. I urge you to read "Engaging Health Care Users" and rethink what engagement looks like in your community.

Katherine Keene (, is COG chair and a trustee of Salem (Ore.) Hospital.